Deutsche medizinische Wochenschrift
-
Dtsch. Med. Wochenschr. · Apr 2020
[Abdominal Sonography in Medical Emergencies: do Complete Abdominal Scans offer Advantages over a Focused Strategy?]
To determine, whether in case of abdominal emergencies, complete abdominal ultrasound scans offer advantages over a goal-directed strategy in regard to problem-solving and detection of relevant pathologies. ⋯ In medical abdominal emergencies, ultrasound scans of the complete abdomen detect more relevant pathologies and solve more problems than focused sonography does.
-
Dtsch. Med. Wochenschr. · Apr 2020
[Sequential Natriuretic Peptide Measurements to Monitor Treatment and Prognosis During Heart Failure Therapy].
Natriuretic peptide serum levels (NP) are the most robust predictors of heart failure (HF) diagnosis and prognosis. Therefore, international HF guidelines give highest evidence and recommendation on their clinical usage, particular in patients with dyspnea. Key message of this review is to inform about the concept of sequential NP measurements as quantifiable plasma biomarker to objectify sodium-water-dynamics and clinical therapy response during recompensation of HF patients. Essentially, three clinical scenarios result of sequential NP measurements and might have a valuable role in HF risk stratification, prognosis and need of therapy optimization of in- and outpatient care.
-
A 33-year old Romanian chef presented with sudden onset of chest pain and chills as well as a significant elevation of myocardial markers and CRP. ⋯ Myocarditis is a rare manifestation of Q fever, which should not be missed. The diagnostic evaluation with antibody titers is easy. The antibiotic therapy is well tolerated and is a causal treatment that helps to prevent long-term damage.
-
Dtsch. Med. Wochenschr. · Apr 2020
[Cardiovascular infections - recent progress and future challenges].
Patients with previous endocarditis are at highest risk of infective endocarditis (266-fold compared to the general population) - preventive strategies are of particular importance in this patient subgroup. Patients with community-acquired E. faecalis bacteremia should undergo transesophageal echocardiography - according to a recent study the prevalence of endocarditis may be ≥ 20 % in this setting. Several smaller observational studies suggest an association between E. faecalis endocarditis and colorectal neoplasias - colonoscopy should therefore be offered to patients with newly diagnosed E. faecalis endocarditis (particularly in patients with unknown portal of entry). ⋯ Approximately one out three patients with a left ventricular assist device (LVAD) will suffer from LVAD-related infections during the first year after implantation. Appropriate antibiotic treatment and adequate surgical debridement are essential management strategies.
-
Dtsch. Med. Wochenschr. · Apr 2020
[Interstitial lung disease in rheumatic diseases - new therapeutic approaches].
Pulmonary involvement is an important aspect in the management of rheumatic diseases. Connective tissue disease-associated interstitial lung diseases (CTD-ILD) are of particular importance, as their occurrence is often decisive for patient outcome. We use corticosteroids, immunosuppressants and eventually also biologicals in the therapy of CTD-ILD. ⋯ Currently a number of other studies regarding the effectiveness of antifibrotics in CTD-ILD are expected to be published. The studies in this field bring new aspects in the understanding of interstitial diseases and have the potential of expanding treatment options in CTD-ILD. The topic of CTD-ILD is a difficult, but at the same time exciting field.